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Dos Santos AP, Cordeiro JFC, Abdalla PP, Bohn L, Sebastião E, da Silva LSL, Tasinafo-Júnior MF, Venturini ACR, Andaki ACR, Mendes EL, Marcos-Pardo PJ, Mota J, Machado DRL. Low handgrip strength is associated with falls after the age of 50: findings from the Brazilian longitudinal study of aging (ELSI-Brazil). Arch Public Health 2024; 82:172. [PMID: 39354567 PMCID: PMC11446049 DOI: 10.1186/s13690-024-01340-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/03/2024] [Indexed: 10/03/2024] Open
Abstract
AIM This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life. METHODS This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions. RESULTS A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables. CONCLUSIONS Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s.
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Affiliation(s)
- André Pereira Dos Santos
- Faculty of Sport of the University of Porto, Street Dr. Plácido da Costa 91, Porto, 4200-450, Portugal.
- College of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
- Human Exposome and Infectious Diseases Network (HEID), Ribeirão Preto, Brazil.
| | | | - Pedro Pugliesi Abdalla
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lucimere Bohn
- Center for Research in Sport, Physical Education, Exercise, and Health (CIDEFES), Lusófona University - University Center of Porto, Porto, Portugal
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, United States
| | - Leonardo Santos Lopes da Silva
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Márcio Fernando Tasinafo-Júnior
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ana Cláudia Rossini Venturini
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Alynne Christian Ribeiro Andaki
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Edmar Lacerda Mendes
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- Federal University of Triângulo Mineiro, Uberaba, Brazil
| | - Pablo Jorge Marcos-Pardo
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- Centro de Investigación para el Bienestar y la Inclusión Social (CIBIS Research Center), SPORT Research Group (CTS-1024), Almería, Spain
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
| | - Dalmo Roberto Lopes Machado
- College of Nursing of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Study and Research Group in Anthropometry, Training and Sport, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sports, University of Porto, Porto, Portugal
- School of Education and Communication (ESEC), University of Algarve, Penha Campus, Faro, Portugal
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Costa Pereira JPD, Gonzalez MC, Prado CM, Cabral PC, Nascimento TGD, Nascimento MKD, Diniz ADS, Ramiro CPSP, Fayh APT. Body mass index-adjusted calf circumference is associated with mortality in hospitalized older patients with excess weight. Nutrition 2024; 125:112505. [PMID: 38981374 DOI: 10.1016/j.nut.2024.112505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Given the innovative nature of the method, our study aimed to assess the prognostic significance of body mass index (BMI)-adjusted calf circumference (CC) in older patients who are hospitalized. METHODS This was a unique analysis as part of other cohorts comprising general hospitalized patients aged 60 years or older of both sexes. Only patients with excess weight (BMI ≥ 25 kg/m2) were included. CC was adjusted by reducing 3, 7, or 12 cm for BMI (in kg/m2) within 25-29.9, 30-39.9, and ≥40 kg/m2, respectively. CC was considered low if ≤ 34 cm for males and ≤ 33 cm for females. Clinical outcomes included prolonged length of hospital stay (LOS) and mortality. RESULTS A total of 222 patients were included. After BMI adjustments, 72.1% of the patients were reclassified from a normal CC category to a low CC category. The frequency of low CC increased from 33.8% to 81.9% following BMI adjustments. Among those reclassified to the low CC, 11 died, compared to only 2 patients in the group that maintained a normal CC classification. BMI-adjusted CC was inversely associated with mortality (HR adjusted 0.84, 95% CI 0.73 to 0.95), but not with prolonged LOS. CONCLUSIONS Our novel study highlights the prognostic value of BMI-adjusted CC. As an anthropometric marker of muscle mass, it proved to be a predictor of mortality in older patients with high BMI. This adjustment is further important because it may help to better detect low muscle mass in these patients where such conditions might be masked.
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Affiliation(s)
- Jarson Pedro da Costa Pereira
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Poliana Coelho Cabral
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Tais Galdencio do Nascimento
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Maria Karolainy do Nascimento
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Alcides da Silva Diniz
- Postgraduate Program in Nutrition and Public Health, Department of Nutrition, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Claudia Porto Sabino Pinho Ramiro
- Hospital of Clinics, Federal University of Pernambuco, Recife, Pernambuco, Brazil; Brazilian Company of Hospital Services, EBSERH, Recife, Pernambuco, Brazil; Emergency Cardiology Unit of the University of Pernambuco, Recife, Pernambuco, Brazil
| | - Ana Paula Trussardi Fayh
- Postgraduate Program in Health Science, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; PesqClin Lab, Onofre Lopes University Hospital, Brazilian Company of Hospital Services (EBSERH), Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Kiss CM, Bertschi D, Beerli N, Berres M, Kressig RW, Fischer AM. Calf circumference as a surrogate indicator for detecting low muscle mass in hospitalized geriatric patients. Aging Clin Exp Res 2024; 36:25. [PMID: 38321234 PMCID: PMC10847205 DOI: 10.1007/s40520-024-02694-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Sarcopenia is characterized by low muscle strength, decreased muscle mass, and decline in physical performance. While the measurements of muscle strength and physical performance are easy to perform, an accurate evaluation of muscle mass is technically more demanding. We therefore evaluated the suitability of calf circumference (CC) as a clinical indicator for muscle mass. METHODS In a cross-sectional single-centre study, geriatric inpatients were assessed for sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) consensus. Calf circumference was tested for correlation with appendicular skeletal muscle mass index (ASMI). Receiver operating characteristic curves (ROC) were used to calculate the discriminatory value of the CC cut-off values to differentiate patients above and below ASMI cut-offs for sarcopenia. RESULTS In this study population (n = 305, age 83.5 ± 7.0 years, BMI 25.7 kg/m2, 65.6% female), the prevalence of sarcopenia was 22.6%. In subjects with low ASMI, mean CC was 29.5 ± 3.4 cm for females and 32.0 ± 3.4 cm for males. A positive relationship between CC and ASMI was found. The optimized cut-off value for CC to identify patients with low ASMI was <31.5 cm for females (sensitivity 78%, specificity 79%), and <33.5 cm for males (sensitivity 71%, specificity 62%). CONCLUSION In clinical settings where imaging technology for muscle mass quantification is not available, simple calf circumference measurement may be used as a dependable indicator for low muscle mass in older adults.
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Affiliation(s)
- Caroline M Kiss
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Dominic Bertschi
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Department of Geriatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nadine Beerli
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- Institute of Nursing Science, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Andreas M Fischer
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland.
- University of Basel, Basel, Switzerland.
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Mazzini LR, Aquino JLBD, Camargo JGTD, Leandro-Merhi VA. IS CALF CIRCUMFERENCE ASSOCIATED WITH CLINICAL AND NUTRITIONAL OUTCOME IN OLDER PATIENTS? ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2023; 36:e1773. [PMID: 37971026 PMCID: PMC10642954 DOI: 10.1590/0102-672020230055e1773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 09/02/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Previous studies have shown a relationship between calf circumference (CC) and outcomes in hospitalized patients. AIMS To investigate the relationship between CC and clinical and nutritional outcomes in older in-patients (OiP) in a surgery ward. METHODS This was a cross-sectional study with 417 OiP in a surgery ward. Clinical variables, anthropometry, and nutritional screening instruments such as subjective global assessment (SGA), mini nutritional assessment (MNA), and nutritional risk screening (NRS) were used in the investigation. The tests Pearson's chi-square, Mann-Whitney, Kruskal-Wallis, and Spearman's coefficient, and multiple linear regression analyses were used to review the factors associated with CC. RESULTS Lower CC values were found in the age group 80 years and over (p<0.0001), presence of complications (p=0.0269), NRS (p<0.0001), SGA (p<0.0001), and MNA (p<0.0001). Gender (p=0.0011; partial R2=0.01151), age (p=0.0002; partial R2=0.06032), body mass index (p≤0.0001; partial R2=0.40820), and arm circumference (p≤0.0001; partial R2=0.11890) are variables that together were associated with CC. There was also a relationship between SGA (p=0.0166; partial R2=0.00605) and absence of complications during hospitalization (p=0.0047; R2=0.01154) with CC. CONCLUSIONS Gender, age, body mass index, and arm circumference were jointly associated with CC, in addition to SGA and absence of complications. The CC is a relevant indicator for OiP in the clinical practice.
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Affiliation(s)
- Lucas Rosasco Mazzini
- Pontificia Universidade Católica de Campinas, School of Medicine - Campinas (SP), Brazil
| | - José Luis Braga de Aquino
- Pontificia Universidade Católica de Campinas, School of Medicine - Campinas (SP), Brazil
- Pontificia Universidade Católica de Campinas, Postgraduate Program in Health Sciences - Campinas (SP), Brazil
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